Amirtharajah Mohana, Fufa Duretti, Lightdale Nina, Weiland Andew
Mission Bay Ortho Institute, San Francisco, CA, USA.
Iowa Orthop J. 2011;31:140-4.
The purpose of this study was to evaluate the one-year clinical, radiologic and patient-reported results of surface-replacing proximal interphalangeal joint arthroplasty (SR-PIP) of the hand. Fifteen patients with 18 joints underwent the procedure, and nine patients with 11 joints had follow-up of at least one year's duration. Of these joints, six had a diagnosis of osteoarthritis with no history of trauma, three had post-traumatic arthritis, one had psoriatic arthritis, and one had erosive arthritis. The mean clinical follow-up was at 3.3 years, and the mean radiographic follow-up was at 3.1 years. The average post-operative gain in range of motion at the PIP joint was 28 degrees and was statistically significant. Six patients completed self-reported questionnaires at a mean of 4.8 years post-operatively. The mean Disabilities of the Arm, Shoulder and Hand (DASH) score post-operatively was 17, and the Michigan Hand Questionnaire (MHQ) score for overall satisfaction was 70. There were three complications but only one reoperation. Seven of 11 joints showed some evidence of subsidence on follow-up radiographic examination. However, no joints were revised secondary to loosening. Longer follow-up is needed to determine if this observable radiologic subsidence leads to symptomatic loosening of the implant.
本研究的目的是评估手部表面置换近端指间关节成形术(SR-PIP)的一年临床、影像学及患者报告结果。15例患者的18个关节接受了该手术,9例患者的11个关节获得了至少一年的随访。在这些关节中,6个诊断为骨关节炎且无创伤史,3个为创伤后关节炎,1个为银屑病关节炎,1个为侵蚀性关节炎。平均临床随访时间为3.3年,平均影像学随访时间为3.1年。PIP关节术后活动度平均增加28度,具有统计学意义。6例患者在术后平均4.8年完成了自我报告问卷。术后手臂、肩部和手部功能障碍(DASH)平均评分为17分,密歇根手部问卷(MHQ)总体满意度评分为70分。出现了3例并发症,但仅1例进行了再次手术。11个关节中有7个在随访影像学检查中显示出一定程度的下沉迹象。然而,没有关节因松动而进行翻修。需要更长时间的随访来确定这种可观察到的影像学下沉是否会导致植入物出现症状性松动。